Wiener medizinische Wochenschrift
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Wien Med Wochenschr · Jan 2008
Review[Biologics in the early treatment of ankylosing spondylitis and related forms of spondyloarthritis].
New pathogenetic insights have identified the key role of TNF-alpha in inflammatory rheumatic diseases and have revolutionized the therapy of spondyloarthritides. TNF-alpha-antagonists specifically inhibit the pro-inflammatory effects of TNF-alpha. Clinical studies with infliximab (Remicade), Etanercept (Enbrel) or Adalimumab (Humira) in ankylosing spondylitis or related diseases demonstrate superior efficacy to conventional drugs like non-steroidal antirheumatic drugs or traditional disease modifying antirheumatic drugs.
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Delirium is a common complication in palliative care of preterminally or terminally ill cancer patients. Based on a case report of a delirious male patient with cerebral metastasis, typical manifestations, etiologies, risk factors and possible therapies of palliative delirium will be reviewed. Furthermore, difficult therapeutic decisions with regard to the use of corticosteroids, fentanyl and parenteral rehydration therapy will be discussed.
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This article about cohort studies is part of a methods series about study designs and their critical evaluation by the Ludwig Boltzmann Institute for Health Technology assessment. This article aims to describe the theoretical concept of cohort studies and their typical characteristics. Furthermore, it strives to highlight advantages and disadvantages of this study type and to make suggestions for the critical evaluation of the significance and validity of cohort studies. ⋯ Problems of blurring results by selection bias and confounding are also discussed. Cohort studies are applied in situations where the effects of environmental exposures are measured and rare side effects are identified but randomised controlled studies did not show significant results because of limitations. They are also used to assess the incidence of a disease or a condition.